Many in B.C. recognize Hope as the travel stop for ice cream, a Tesla charge or even a $2 used book store between the Lower Mainland and the rest of the province, and would see little evidence of how hard it's been hit by the toxic drug overdose crisis and community leaders' desperate efforts to keep people alive.
The district municipality of Hope, known as a work-hard, play-hard logging town, defined by a verdant central park and chainsaw wood carvings, is ringed by picturesque mountains and sits at the confluence of the Fraser and Coquihalla rivers, about an hour and 45 minutes drive from Vancouver.
It has fewer than 7,000 residents, but lost 11 of them in 2023 to toxic drugs.
"People think, 'oh it's 11,' but it's a big number for a community," said Gerry Dyble, who has lived in the Fraser Valley community for 30 years and is the executive director of the Hope and Area Transition Society (H.A.T.S.), which offers support for drug addiction, among other services.
Hope and Area Transition Society executive director Gerry Dyble, pictured in Hope, B.C., on Jan. 31, says lacking transportation to treatment services is an obstacle for many in the community who are struggling with addiction. (Ben Nelms/CBC News)
The 11 deaths, out of 2,511 province-wide last year, gave Hope the dubious distinction of having the highest-per-capita unregulated drug deaths of any B.C. municipality, at nearly 124 per 100,000 people.
Dyble is one of several community members scrambling to respond to the surge in overdose deaths in Hope and its large rural health-care catchment area since 2016.
"Transportation is an issue," she said. "[If] you have no transportation you might as well live a million miles away from services."
Dyble says the deaths are occurring across demographics, including people living in tents, workers, and members of local Indigenous communities.
'A text away'
Michael McLoughlin came to Hope in 1986 from Vancouver to work as one of three pharmacists in the town because he wanted to develop long-lasting relationships with residents and their families.
"I'm probably on ... my fourth generation of some families," he said "'Go to Mike,' the grandparents say, 'he's helped us.'"
Addictions, whether to alcohol or other substances, have been something McLoughlin has tried to help his patients with, but starting around 2015 he began noticing a serious development. The illicit substances people in his community were taking were becoming increasingly toxic, and a spike in deaths soon followed.
Hope Pharmasave pharmacy manager Michael McLoughlin is pictured at his store in downtown Hope, B.C., on Wednesday, Jan. 31, 2024. (Ben Nelms/CBC News)
The partner of a staff member, a recreational drug user, died of an overdose after the toxic drug crisis was declared a public health emergency in 2016.
"It's tragic, it's very sad, yes I feel terrible … a loved one thinking they are just going to celebrate a birthday," he said.
McLoughlin's pharmacy and others developed a rapid access program for people coming to the pharmacy struggling with addictions.
McLoughlin texts a physician in town, who then speaks with the patient over the phone about a plan for medication, which would be administered as a stop gap to help the patient avoid withdrawal and buy time to connect them with other services.
"A text away," said McLoughlin.
"Once you start them on their drugs, it's much easier for them to not consume … because they are already getting some help and that allows them the frame of mind and the ability to actually go to a subsequent appointment."
Streets are seen in downtown Hope on Wednesday, Jan. 31. The town of fewer than 7,000 residents lost 11 people in 2023 to toxic drugs. (Ben Nelms/CBC News)
The person often on the other end of that text is Dr. Aseem Grover, who after growing up in Abbotsford, studying medicine and doing a residency at St. Paul's Hospital in Vancouver, started his rural practice just as the toxic drug crisis began expanding in 2016.
Almost immediately he recognized Hope and its vast surrounding community, up the Fraser Canyon north and south to Manning Park, was lacking resources to deal with toxic drugs and its victims.
His response so far has included renting a bus to drive patients to and from treatment and appointments, handing out naloxone kits to patients and drug dealers, rallying other community health workers to a co-ordinated response, and now setting up a special, secondary services clinic on Hope's main street.
"A one-stop shop for a lot of our vulnerable people," he said. "We know that their journey to access services is extremely challenging."
A person stands on the side of a street in Hope on Wednesday, Jan. 31. (Ben Nelms/CBC News)
Despite the effort and several success stories, the toxic drug death numbers have only gotten worse, going from seven in 2020 to last year's 11.
"The numbers would be a lot worse, that's the reality," said Grover about efforts to reverse the trend. "We're trying to jump on whatever opportunities to get ahead of the curve."
In showing off the clinic he helped set up, which can offer counselling, drug testing and other services in Hope, he showed artwork some of his patients have made as part of their journey to recovery. Sadly some patients, such as one who carved a beautiful moose from wood, relapsed and ultimately died before he could get the help he needed.
Dr. Aseem Grover is pictured with a piece of artwork a former patient gifted to him at the Fraser Canyon Clinic in downtown Hope. (Ben Nelms/CBC News)
"Art from people that are doing well, that are recovered, they come and meet you … in moments when they are doing well, it means a lot," he said.
"You are making a difference, sometimes you only focus on the negative because you see bad numbers ... you have to focus also on that you are meaning well, doing well, the best you can."
Kelsey John, a councillor with the Chawathil First Nation, whose unceded territories include Hope, said he acknowledges efforts community leaders are making to address toxic drug deaths in the municipality and surrounding area, but the numbers are stark and Indigenous people are overrepresented.
"It's rattling," he said. "It tugs on the heartstring because that's a community member of Chawathil."
The nation, which has around 650 members and is part of the 11 communities that make up Stó:lō Nation, has rallied to obtain grants from the First Nations Health Authority to support harm-reduction measures.
Chawathil has also partnered with neighbouring nations to offer land-based healing programs.
"What can we do to help and support our members and … reduce harm?" he said. "I think the accessibility piece needs to be emphasized."
A resident of Hope stands by his scooter in the town's downtown on Jan. 31, 2024. The town is part of the Chawathil First Nation's unceded territories. (Ben Nelms/CBC News)
John wants to see more wraparound services to tackle substance use in towns like Hope, such as increasing the number of counsellors available. Since 2007 there has only been one for adults in the community, said Dyble.
Perhaps the biggest missing piece is appropriate transportation to access health-care services such as treatment and recovery beds.
The closest are at least a 30-minute drive away, said Grover. B.C. Transit began providing service from Hope to Chilliwack five years ago, but many like Dyble say the service is still too limited and only takes people there in the morning, only to return in the late afternoon.
B.C.'s Ministry of Mental Health and Addictions did not respond in time for publication to questions about how many of 285 treatment and recovery beds across the province were accessible in the Fraser Valley and Fraser Canyon, or how the province was supporting smaller communities over transportation challenges.
Earlier Health Minister Adrian Dix told CBC News his government recognized the unique challenges smaller communities were facing over the crisis.
"It requires, of course, supports for housing and community," he said.
Fraser Health said it has several initiatives, which include offering taxi vouchers, and help from a community program, which provides rides to people needing to get to overdose prevention sites and treatment services.
"We continue to work closely with the provincial government and our community stakeholders to ensure people in Hope and the surrounding areas can access the right services when they need them," said the health authority in a release.
Victor A. Smith, mayor of the district of Hope, is pictured in Hope, B.C., on Wednesday, Jan. 31, 2024. (Ben Nelms/CBC News)
Community members like Hope Mayor Victor Smith are counting on more shelter space and low-barrier housing coming to the community over the next couple of years to help reduce toxic drug deaths.
"We need more help to try and get the numbers down," he said, "but we have team players who are trying."